Have you ever been referred for a medical imaging procedure but felt unsure about the terms on your referral note or what to expect? If “fluoroscopy” is one of those terms, we are here to help and to explain it as one of the tricky terms of radiology.

What does ‘fluoroscopy’ mean?

Fluoroscopy is a medical imaging technique that uses continuous X-ray beams to view movement inside the body while it happens (think X-ray ‘movie’).

In the radiology department, it allows radiologists to observe organ function and the movement of joints or to examine the gastrointestinal tract. In the operating theatre, it guides surgeons while doing surgical procedures.

The real-time visuals are transmitted to a monitor and every movement is seen in detail.

What happens during a fluoroscopy procedure?

If you’ve been referred for a fluoroscopy procedure, you will typically be positioned on a specially designed X-ray machine. A contrast dye (like barium or iodine) will be introduced into your body to make certain areas more visible. Depending on the type of exam, you may need to move a joint or stand on a tilting platform to help capture clearer images. The X-ray machine then creates continuous visuals of the area, which the radiologist can analyse.

Why do you undergo fluoroscopic imaging?

Fluoroscopy has many applications but can be roughly divided into two categories:

• Diagnostic procedures for which you’ll be referred to a radiology department.
• Guidance of surgical or minimally invasive procedures, where a radiographer will operate the equipment under the guidance of a surgeon or radiologist in the operating theatre or imaging room.

Diagnosing conditions
Depending on the type of exam, diagnostic fluoroscopy procedures often have specific names.

• Barium swallow: To check the oesophagus and swallowing function
• Barium meal: To check the stomach and small intestines
• Barium enema: To evaluate the large bowel
• Arthrogram: To evaluate a joint, often part of an MRI examination
• Cystogram: To evaluate the bladder

Guiding surgical procedures

• The placement of catheters, stents, or other devices in the body
• Guiding injections of the spine or joints
• Guiding joint replacements and fracture repairs
• Guiding the placement of intravenous or intra-arterial catheters
• Guiding the placement of needles and tubes

What to remember

Fluoroscopy is essentially a safe procedure but, as with any X-ray-based technique, radiation exposure is a consideration, especially since the exposure is continuous during the procedure.

As in any procedure using radiation, the ALARA principle is always applied. It stands for ‘as low as reasonably achievable’ and is a key principle in radiation safety, ensuring exposure is minimized while maintaining image quality. Doctors will always ensure that the benefits outweigh the risks when they recommend the procedure.

Medical staff will also do safety checks for known allergies and kidney function if appropriate, before introducing the contrast material into the body. Referred patients may also notice side effects such as constipation after a barium swallow and are advised to drink plenty of fluids after their exam.

What to expect

• You may be asked to avoid eating or drinking before the procedure, especially if you’re having a fluoroscopy exam of the digestive system.
• The procedure may take anything from 15 minutes to an hour, depending on what is being examined.
• You may feel a warm sensation or mild discomfort when the contrast is administered, but this is normal and not of any concern.
• You will need to keep still during the procedure to ensure the images are clear.
• Afterward, you may be able to return to your normal activities unless otherwise instructed by your doctor.

Results

You can typically expect your fluoroscopy results within a few hours of your procedure. Your images and report will be sent to your referring doctor, who will discuss the findings with you.

In some cases, results might be available even sooner, depending on the facility and urgency of the exam.

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• This article is part of a series aimed at decoding radiology jargon for patients. Visit our news section for more.
• The article is intended to create awareness and none of the information it contains should replace the need for seeking personal advice from a qualified medical practitioner.
• Apart from selected screening examinations, all radiology procedures are performed upon referral from a qualified medical professional.